Should the spot albumin-to-creatinine ratio replace the spot protein-to-creatinine ratio as the primary screening tool for proteinuria in pregnancy?

Abstract

OBJECTIVES: To determine the correlation between the spot albumin-to-creatinine (ACR) ratio and protein-to-creatinine ratio (PCR) in pregnancy and if either test is predictive of adverse pregnancy outcome. STUDY DESIGN: Prospective consecutive cohort study in a single tertiary centre examining 181 patients undergoing proteinuria screening after 20weeks of pregnancy. A spot PCR and ACR was performed on the first void of the day. Comparison was with linear and logistic regression and ROC curve. Optimal values for the ACR were obtained and compared to a PCR value of 30mg/mmol with respect to adverse pregnancy outcomes. MAIN OUTCOME MEASURES: Birth weight <10th centile, preterm birth <32 and <37..